Book Review

Radiographic Atlas of Child Abuse: A case studies approach

N Engl J Med 1996; 335:441August 8, 1996

Article

Radiographic Atlas of Child Abuse: A case studies approach
By Vivian J. Harris, Michele A. Lorand, John J. Fitzpatrick, and Demetra K. Soter. 239 pp., illustrated. New York, Igaku-Shoin, 1996. $89.50. ISBN: 0-89640-258-4

This book reflects the experience of the Child Abuse Team at Cook County Hospital and the Office of the Medical Examiner of Cook County. In the preface the authors highlight the increased incidence of child abuse and estimate that more than three children die each day in the United States as a result of abuse. The book consists of illustrated case histories followed by discussion and references. These are grouped into chapters, the longest being on head injury, the most common manifestation of child abuse. Other chapters cover all the bony and visceral manifestations of child abuse, along with techniques of forensic pathology. There are two short chapters on the use of radiographic projections in cases of suspected child abuse and the role of bone scintigraphy.

This book is an atlas, not a comprehensive textbook, and will not compete with Paul K. Kleinman's Diagnostic Imaging of Child Abuse (Baltimore: Williams and Wilkins, 1987). As an atlas it suffers from repetition, both in the types of injury illustrated and in the references. It contains most of the important information that court-appointed experts need. The questions of the specificity of retinal hemorrhages and the cause of posterior rib fractures are discussed in the text, along with an aid for help in dating fractures. The index could have been more comprehensive. The book has several poorly reproduced images, and one is printed upside down. Some images lack the illustrative arrows mentioned in the text. This book has several spelling errors, including “country” for (Cook) “County,” and some of the references are incorrect. These shortcomings notwithstanding, the book has interesting and useful information for physicians involved in diagnosing child abuse.

Philip Stanley, M.D.
Children's Hospital of Los Angeles, Los Angeles, Ca 90027